Provider Demographics
NPI:1134649916
Name:MATHER, ELISABETH KEIKO KURASHIGE (LMHC)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:KEIKO KURASHIGE
Last Name:MATHER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:594 MANANAI PL APT W
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-5380
Mailing Address - Country:US
Mailing Address - Phone:808-387-0098
Mailing Address - Fax:
Practice Address - Street 1:3140 WAIALAE AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1510
Practice Address - Country:US
Practice Address - Phone:808-735-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
HIMHC-758101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program